The text of the latest revision to the U.S. Senate’s bill to repeal and replace the Affordable Care Act has been released publicly:
Based on this latest revision, the Congressional Budget Office has updated its estimate of the impact the bill, maintaining its estimate that, by 2026 (after ten years), the bill would increase the number of uninsured Americans by 22 million. The national rate of uninsured would nearly double from 10% to 18%. However, the revisions would mean that the number of Americans losing their health insurance would occur slightly slower, with 15 million losing their coverage next year, compared with 17 million under the prior version of the bill. Medicaid spending would be cut by $756 billion, resulting in 15 million Americans losing Medicaid coverage. $396 billion in tax credits to assist low-income and working Americans afford their health insurance would be cut.
Since the revised bill retains some of the ACA taxes (primarily $172 billion from the surtax on certain high-income taxpayers’ net investment income accounting and $59 billion from the Medicare payroll tax for certain high-income taxpayers, the amount of total cost savings/deficit reduction does increase under the revised bill, to $420 billion over ten years.
Senate Majority Leader Mitch McConnell has announced that he intends to call for a vote on a motion to proceed with an alternative bill that simply repeals the health insurance and Medicaid expansions under the ACA (and all its taxes). However, if that legislative strategy changes again and there is a vote on a motion to proceed with a “repeal and replace” bill, this is the text that would now be voted on. If either bill passes the motion to proceed (still highly unlikely given unanimous opposition from all the Democratic Senators and publicly announced opposition by sufficient numbers of Republican Senators that would fall short of the 51 votes needed for any motion to proceed), there would be opportunity to introduce, debate, and vote on additional amendments during the proceedings on the Senate floor.